Allo-SCT for high-risk AML-CR1 in the molecular era: impact of FLT3/ITD outweighs the conventional markers.

Sengsayadeth SM, Jagasia M, Engelhardt BG, Kassim A, Strickland SA, Goodman S, Lucid C, Vnencak-Jones CL, Greer JP, Savani BN
Bone Marrow Transplant. 2012 47 (12): 1535-7

PMID: 22659680 · DOI:10.1038/bmt.2012.88

Seventy-nine patients with AML in CR1 received allo-SCT between May 2006 and May 2011, and the prognostic impact of FMS-like tyrosine kinase 3/internal tandem duplication (FLT3/ITD) mutation was evaluated in the context of other clinical prognostic factors. Patients with FLT3/ITD + AML had significantly inferior DFS (2-year DFS: 19% vs 64%, P = 0.0027), increased risk of relapse (1-year: 59% vs 19%, P = 0.01), and a trend towards decreased OS (P = 0.08) compared with patients without FLT3/ITD. Multivariate analysis confirmed FLT3/ITD + independently predicted a shorter DFS (HR, 3.0; 95% CI), 1.4-6.5; P = 0.01) and increased risk of relapse (HR, 4.9; 95% CI, 2.0-12.3, P = 0.01). Time to relapse in patients with FLT3/ITD + was short with 100-day cumulative risk of 45% (95% CI, 33-57). Our data suggest that the poor prognostic implication of FLT3/ITD positivity remains even after early allo-SCT in patients with FLT3/ITD + AML, and patients remain at high risk of early relapse. FLT3/ITD positivity also outweighs other conventional prognostic markers in predicting relapse.

MeSH Terms (20)

Adult Aged Aged, 80 and over Antineoplastic Combined Chemotherapy Protocols Biomarkers, Tumor Combined Modality Therapy Female fms-Like Tyrosine Kinase 3 Humans Leukemia, Myeloid, Acute Male Middle Aged Mutation Prognosis Stem Cell Transplantation Survival Analysis Tandem Repeat Sequences Transplantation, Homologous Treatment Outcome Young Adult

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